How to Ensure Your Practice is Paid for Medicaid Services January 23, 2026

Please see below from DC Medicaid

As you are aware, DHCF is transitioning to a new fiscal agent / claims payment vendor – Gainwell - on March 2, 2026. Beginning March 2nd, Gainwell will be responsible for:

• Adjudication and payment of valid health care claims;
• Operating the call centers for provider inquiry and Electronic Data Interchange (EDI) technical support; and
• Provider, beneficiary, and other provider inquiry web portal functions.

Provider training sessions kicked off on January 6, 2026, and will continue through the transition period. To register for training, providers must access the MMIS Learning Center at https://mmislearningcenter.myabsorb.com as referenced in the introductory training email providers received from Gainwell.

Last week, Gainwell sent a letter to providers with an overview of what to expect with the transition and the steps providers need to take starting February 2, 2026, to register with the new system. It is imperative that providers register prior to March 2nd – if providers fail to register with the new system, they will not be able to submit claims and receive payment. A sample of the letter is attached for your awareness, and I ask that you amplify the letter and its messaging with your members. Your support will help ensure a seamless transition.

I also want to call to your attention to the impact on the payment cycle once the new system goes live. There will be a one-week delay in payment when the new system goes live. Specifically, there will be no payments made on Friday, March 6, 2026. The first payments from the new Gainwell system will occur on Friday, March 13, 2026. Providers should plan accordingly if they are accustomed to weekly payments.

As of Tuesday, the new Gainwell portal is live and can be accessed at https://medicaid.dc.gov. If you look under the Provider tab, you will find the links to provider training and more information. Below recaps the key dates starting this month going forward.     

January 6th: Provider training sessions kicked-off
January 20th: Portal go-live (https://medicaid.dc.gov)
February 2nd: Provider registration opens
March 2nd: System go-live
March 13th: First payment from the Gainwell system